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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2020; 41(02): 173-181
DOI: 10.4103/ijmpo.ijmpo_2_20
Review Article

Upfront Maintenance Poly(Adenosine Diphosphate Ribose) Polymerase Inhibitors in Ovarian Cancer: A Ray of Hope or Just a Mirage!

Avinash Pandey
Department of Medical Oncology, State Cancer Institute, IGIMS, Patna, Bihar
,
Joydeep Ghosh
Consultant, Medical Oncologist, Tata Medical Center, Kolkata, West Bengal
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Poly(adenosine diphosphate ribose) polymerase inhibitors (PARPis), when used in patients harboring tumor with homologous recombination deficiency, with or without BRCA mutation, have shown favorable outcomes in relapsed, advanced metastatic breast and ovarian cancers. Olaparib, niraparib, and rucaparib have been approved as maintenance therapy in platinum-sensitive, relapsed, high-grade epithelial ovarian cancer (EOC) responsive to platinum doublet. Olaparib and rucaparib as monotherapy are also indicated in patients who have progressed on three or more lines of chemotherapy, irrespective of platinum sensitivity, in germline or somatic BRCA 1/2-mutated, PARPi-naive patients. Recently, four large multicentric, international Phase III randomized clinical trials have reported outcomes of PARPi in first-line advanced EOC as maintenance therapy either alone or in combination with bevacizumab. Previously bevacizumab, pazopanib, nindetanib, or maintenance chemotherapy in first-line setting has resulted in modest improvements in progression free survival, albeit with significant toxicities and poor cost-effectiveness. We offer in this review to dissect the data pertaining to randomized clinical trials of PARPi use as maintenance therapy in upfront EOCs and ruminate about its role in the contemporary management of ovarian cancers.

Keywords

Epithelial ovarian cancer - maintenance therapy - poly (adenosine diphosphate ribose) polymerase inhibitors


Publication History

Received: 07 January 2020

Accepted: 02 February 2020

Article published online:
23 May 2021

© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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